Tsai H D, Chang C C, Hsieh Y Y, Chang C C, Yang T C, Chen C M
Department of Obstetrics and Gynecology, China Medical College Hospital, Taichung, Taiwan.
J Clin Ultrasound. 1998 Mar-Apr;26(3):159-62. doi: 10.1002/(sici)1097-0096(199803/04)26:3<159::aid-jcu9>3.0.co;2-l.
Ectopic pregnancy (EP) after in vitro fertilization and embryo transfer (IVF/ET) is not rare, but triplet tubal pregnancy after IVF/ET is very rare. We describe a patient with hydrosalpinx in whom a triplet tubal pregnancy occurred on the same side as the hydrosalpinx. Close hormonal and sonographic monitoring of pregnancies achieved through IVF is recommended to ensure the early diagnosis of EP and to avert complications. A triplet tubal EP was considered highly probable after 3 gestational sacs were observed outside the uterus during sonography performed at 6 weeks' gestation. Therapeutic laparoscopy was then performed because methotrexate treatment failed. Appropriate management strategies are discussed.
体外受精-胚胎移植(IVF/ET)后发生异位妊娠(EP)并不罕见,但IVF/ET后三胎输卵管妊娠非常罕见。我们报告一例输卵管积水患者,其三胎输卵管妊娠发生在与输卵管积水同侧。建议对通过IVF实现的妊娠进行密切的激素和超声监测,以确保早期诊断EP并避免并发症。在妊娠6周时进行超声检查,发现子宫外有3个妊娠囊后,高度怀疑为三胎输卵管EP。由于甲氨蝶呤治疗失败,随后进行了治疗性腹腔镜检查。并讨论了适当的管理策略。